Download Patient Healthcare - Hartford Hospital

Patient Healthcare
Guide
Journal
for patients, family and healthcare providers
Your Medical Team
Physicians:
Residents:
Service
Other Healthcare Providers:
Table of Contents
Our Commitment . . . . . . . . 2
Your Stay . . . . . . . . . . . 3 – 14
Advance Directives . . . . . . . . . . . . . . . 3
Handicap Accessibility . . . . . . . . . . . . 4
Your Care Team . . . . . . . . . . . . . . . . . . 5
Patient Safety . . . . . . . . . . . . . . . . . . . . 7
Quiet Zones . . . . . . . . . . . . . . . . . . . . . . 8
Your Nutrition . . . . . . . . . . . . . . . . . . . . 8
Fall Prevention . . . . . . . . . . . . . . . . . . . 8
Keeping Mobile . . . . . . . . . . . . . . . . . . . 9
Blood Clot Prevention . . . . . . . . . . . . . 9
Pressure Ulcer Prevention . . . . . . . . . . 9
Pain Management . . . . . . . . . . . . . . . 10
Delirium Awareness . . . . . . . . . . . . . 10
Infection Control . . . . . . . . . . . . . . . . 11
Integrative Medicine . . . . . . . . . . . . . 11
Palliative Medicine . . . . . . . . . . . . . . . 11
Available Services . . . . . . . . . . . . . . . 12
Patient Survey . . . . . . . . . . . . . . . . . . 14
Financial Assistance . . . . . . . . . . . . . 14
Family & Visitors . . . 15 – 16
Gift Shop . . . . . . . . . . . . . . . . . . . . . . . 15
Dining Services . . . . . . . . . . . . . . . . . . 15
ATM Machine . . . . . . . . . . . . . . . . . . . 15
Lodging . . . . . . . . . . . . . . . . . . . . . . . . 16
What Every Patient
Needs to Know . . . . . 17 – 20
Welcome to Hartford Hospital
Hartford Hospital is the region’s leading tertiary medical
center with a world-class medical staff of more than
7,000 extraordinary physicians, nurses and other skilled
professionals who are dedicated to delivering the highestquality care in the most compassionate way. Your care
is the focus of everything we do. While you are with us,
we will do everything possible to make your stay as
comfortable as possible.
Hartford Hospital was established in 1854 by the community
for the community. Through the years, we have built a
national reputation for excellence in innovative patient care,
teaching and research. Hartford Hospital performed the first
successful heart transplant in the state and pioneered the
use of robotics in surgery. We maintain the only Level 1
trauma center in the region and operate the state’s only air
ambulance service, LIFE STAR, which has been nationally
recognized for excellence. Our Institute of Living, which
was Connecticut’s very first hospital, is internationally
known for behavioral health care and research.
Hartford Hospital is a member of Hartford HealthCare,
Connecticut’s only truly integrated healthcare system,
which provides a full range of lifetime healthcare services.
Our cancer center is an integral part of the Hartford
HealthCare Cancer Institute, the first member of the
Memorial Sloan Kettering Cancer Alliance, bringing
world-class standards of cancer care to our patients.
Our outstanding programs have been recognized for
excellence by numerous government agencies, U.S. News
and World Report, Solucient, Blue Cross/Blue Shield and
the National Cancer Institute, to name only a few.
We are here first and foremost to meet your needs and
expectations. We welcome your suggestions so that we
can continually improve our services.
I wish you the best on your journey to physical and
emotional healing.
References . . . . . . . . . . . . . . . . . . . . . . 17
Patient Privacy . . . . . . . . . . . . . . . . . . 17
Patient Rights . . . . . . . . . . . . . . . . . . . 18
Medical Records . . . . . . . . . . . . . . . . . 20
Notes, Questions and/or
Instructions . . . . . . . . . . . . . . . . . . . 21-22
Stuart K. Markowitz, MD
President, Hartford Region, Hartford Hospital
Senior Vice President, Hartford HealthCare
Healthcare Representative
Form . . . . . . . . . . . . . . . . . . . . . . . . . . 23-24
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LI V I NG OU R VALU ES
Our Commitment …
Hartford Hospital is committed to providing you with the best patient experience by living
our values of integrity, caring, excellence and safety. We believe that actively involving
patients and families in care improves the flow of information, outcomes and the overall
patient experience.
This Health Care Guide and Journal is a tool that we have developed to improve communication between staff, providers, patients and their families. It provides important information
about being a patient or visitor at Hartford Hospital and provides a place to write down
questions, important issues concerning your care, and a place to share other information.
We welcome your input. If you have any questions, please speak with your nurse or call
your patient advocate at 860.972.1400.
On behalf of the entire team, we thank you for choosing Hartford Hospital.
Sincerely,
Cheryl Ficara, RN, MS, NEA-BC
Hartford HealthCare Regional Vice President
Patient Care Services
2
A Guide for Patients, Family & Healthcare Providers
Jack Greene, MD
Hartford HealthCare Regional Vice President
Medical Affairs
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Contact Information
Advance Directives
To contact a patient in the hospital call
860.545.2711. To contact any department not
listed in the quick reference phone listing,
call 860.545.5000 or 5.5000 from any
hospital phone.
You have the right to make healthcare
decisions about the medical care you receive.
If you do not want certain treatments, you
have the right to tell your physician you do
not want them and to have your wishes
followed. You also have the right to receive
information from your physician to help you
reach a decision about what medical care
is to be provided to you.
The Facility Directory
The facility directory identifies your location
while you are in the hospital. The facility
directory is used by staff throughout the
hospital when a caller or visitor to the hospital
wants to know your location (unit, room
number, telephone number) or if a member
of the clergy is trying to locate you.
If you choose not to be included in the facility
directory your location (unit, room number,
telephone number), even your presence within
the hospital, will not be given out to anyone
who calls or inquires about you, including any
member of the clergy. Also, no mail or flowers
will be delivered to you.
There may come a time when you are unable
to actively participate in determining your
treatment due to serious illness, injury or
other disability. An advance directive is a
legal document through which you provide
your directions or express your preferences
concerning your medical care and/or appoint
someone to act on your behalf. Physicians
and others will use these directives when
you are unable to make or communicate your
decisions about your medical treatment.
A summary of Connecticut law has been prepared
by the Office of the Attorney General for the
Department of Social Services and Department
of Public Health, ©2009. For printed copies,
please visit the Patient Relations Department
or call 860.972.1400.
Upon admission, you determine what
information, if any, is communicated and
to whom it is given. For example, you may
decide that no information is communicated
to anyone, or perhaps you want to designate
only one person to know about your care. You
may also dictate how and where the hospital
sends you written information, including
follow-up appointments.
If you have questions contact the Patient Relations
Department at 860.972.1400 or 2.1400 from any
hospital phone.
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Hospital Accommodations
Your room
Your room assignment is based upon your
admitting diagnosis and the bed availability
on the day of your admission. Private rooms
at Hartford Hospital are based on the clinical
needs of patients.
Calling for assistance
A button to call for assistance is located at
your bedside. When you press the button a
member of the healthcare team will respond.
Tobacco-Free
Environment
Because smoking is a major preventable
cause of disease and death, smoking, including
e-cigarettes and vapor products, are not
allowed on any Hartford Hospital campus.
Your healthcare team will work with you to
help you cope with a tobacco-free environment
and/or quit if you use tobacco products:
• Speak with your physician about medications that might be available to help you quit.
Handicap Accessibility
• Call the QUITLINE at 1.866.END.HABIT
Upon admission, patients are notified of availability of rooms designated to accommodate
the special needs of physically handicapped
person(s). If such a need becomes evident later
in your stay, you will be transferred to a unit/
room with an accessible bathroom as soon as
one is available and the transfer is approved
by your physician. For further information,
contact Patient Relations at 860.972.1400.
• Hartford Hospital Stop Smoking for Life is
available at 860.972.3127 or 2.3127 from any
hospital phone.
Visiting Hours
Receiving visitors is a customized experience.
Please discuss with your nurse and medical
team. Generally, ideal visiting times are
between noon and 8 p.m. You also have the
right to withdraw permission for a person
to visit. A person may be denied visitation if
his/her presence infringes on others’ rights,
safety or is medically or therapeutically
contraindicated.
An adult, other than the patient, is responsible
for supervising and being with a visitor under
the age of 16 at all times.
Individuals with respiratory infections or any
other contagious condition should not visit
patients in the hospital.
If you have any questions about your visitation
rights, please contact Patient Relations at
860.972.1400 or 2.1400 from any hospital phone.
Hartford Hospital asks visitors not to send or
bring latex toy balloons to the hospital due
to latex allergies.
The delivery of flowers/fruit baskets may be
restricted in certain areas for patient safety
(i.e. Critical Care areas).
4
A Guide for Patients, Family & Healthcare Providers
Mobile Phones in the
Hospital Environment
Wireless communication devices may be used
in non-patient areas such as stairways, lobbies,
the cafeteria, conference rooms, offices or
outside on campus grounds.
Wireless communication devices are prohibited in areas where patients are dependent on
monitoring for life support, as well as in locations where patients are receiving therapy.
Valuables
Please send your valuables and non-essential
belongings home with family or friends. If you
must keep any valuables ask your nurse to
secure them in the safe.
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Your Care Team
Attending physician
Provides your medical management and
consultation; provides education and supervision of resident physicians, physician
assistants and nurse practitioners.
Resident physicians
Medical school graduates training in their
specialty are resident physicians. They are
partnered with a teaching professional in
their field. Hartford Hospital is a teaching
hospital so you will work with resident physicians during your stay (see Hartford Hospital
is an Academic Medical Center on page 18).
NP (nurse practitioner) and
PA (physician assistant)
Work in partnership and collaboration with
physician team to oversee your medical care.
Case coordinator
Nurse who follows your medical progress
to ensure that you transition to the correct
level of care at the appropriate time (to another
facility, or home with visiting nurse services
and/or other community providers). You will
meet your case coordinator within 48 hours of
admission and you will be given a brochure
and a business card so that you will have
contact information.
ESA (environmental service associate)
Performs routine housekeeping, supply
and equipment care. Ensures cleanliness
of environment.
Rehabilitation services
Healthcare professionals who will focus
on your ability to move and perform
functional activities.
•
Hospitalist (hospital-based physician)
Provides care to people requiring
hospitalization. The hospitalist will see
you on a daily basis and will manage your
inpatient care, interact with your primary
care physician (PCP) and work with case
coordination on your discharge plan.
PT (physical therapist): examine, diagnose
and treat the body’s muscles, bones and
joints to improve movement and function;
promote fitness and injury prevention.
•
Your hospitalist will not see you once you
are discharged from the hospital. Your PCP
will be notified of your hospitalization
and discharge. Please schedule a follow-up
appointment with your PCP.
OT (occupational therapist): focus on activities of daily living (ADLs) such as bathing
and dressing; assist with recommendations for home and job adaptations;
provide adaptive equipment recommendations and training.
•
SLP (speech language pathologist or speech
therapist): evaluate, diagnose, and treat
patients of all ages with speech, language,
cognition, swallowing, and voice disorders.
Uniform coding
Hartford Hospital uses color-coded uniforms
so patients can easily identify caregivers’ roles.
RN (registered nurse)
Provides nursing care; helps to plan,
organize and direct all aspects of your
daily care.
PCA (patient care associate)
Performs a variety of services including
bathing, toileting, feeding, walking, vital
signs (blood pressure, pulse, temperature)
and electrocardiogram (ECG) under the
supervision of a nurse.
PAA (patient administrative associate)
Assists with meeting patient needs by answering patient call bell. Provides administrative
support for staff, communicates with other
departments.
RT (respiratory therapist)
Evaluate, treat and prevent acute or
chronic problems of the respiratory
(breathing) and cardiac (heart) systems.
Clinical social worker
Assists with personal, family, emotional or
other issues that can result from the stress
of injury, illness, a new diagnosis or other
conditions in the home.
Registered dietitian
Assists with your nutritional care; may include
special or restricted diet, tube feeding or
parenteral nutrition.
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Chaplain
Provides emotional and spiritual support.
Pharmacist
Provides pharmaceutical (medication)
services in collaboration with your doctor
and medical team.
Intentional Rounding
Intentional rounding helps us anticipate your
needs and monitor your well-being so that
you, your family and your visitors can focus
on your recovery. Rounding should occur
multiple times every shift.
Anesthesiologist or nurse anesthetist
Provides anesthetics (medications to keep you
comfortable) and makes sure you’re safe
during surgery.
Patient relations representative
Helps patients and family members with
any questions, concerns, compliments or
problems during a hospital stay.
Volunteers
Help the professional staff meet your needs
and extend hospital resources.
Professional students
Hartford Hospital staff supervise healthcare
providers who are training in many fields,
including nursing, physical rehabilitation,
respiratory care and nutrition.
During rounding you should expect the
nursing team to:
• Address your comfort and pain level
• Help you move and change position
as needed
• Assist you to the bathroom or to walk in
the hallway
• Make sure you have everything you need
in a place where you can reach it
• Ask if there is anything else we can do
for you
If at any time during your stay you have any
concerns, please call the unit manager so we
can address them in a timely manner.
6
A Guide for Patients, Family & Healthcare Providers
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You Are Our Partner in
Safety and Quality
We want you and your family members to feel
like true partners in your plan of care. Your care
team wants you to feel confident to share any
concerns or fears you experience. Patients that
participate in their care as active partners often
experience a more satisfying and successful
hospital stay. Here are some ways that you can
become actively involved in your care.
Patient Safety: Keeping
You Safe
Check Your Name bracelets
Check your name bracelet to make sure
all your name and date of birth is correct.
If something is incorrect or cannot be read,
please tell your nurse. Your caregivers will
frequently be asking you for your first and last
name, as well as your date of birth. We ask you
to tell us your name and date of birth and check
your name bracelet to make sure that you are
the correct patient prior to giving you medications, drawing blood, giving you any treatment,
and before taking you for a test.
Colored wrist bands identify alerts
Colored wrist bands are used to identify alerts
on patients and reflect the standardized
American Hospital Association colors:
• Yellow for fall risk
Medication safety
In addition to your prescription medications, tell
caregivers about all of the medications you are
taking, including vitamins, over-the-counter
drugs (aspirin, antacids, pain relievers, etc.) and
herbal supplements or “natural” products. These
can all have unwanted effects when combined
with medications or anesthesia.
Familiarize yourself with the name, color, size
and dosages of the medications you are taking
in the hospital. Ask questions about why you
are on them, if there are any side-effects, and
if there are any foods or activities you should
avoid while on the medication.
If you do not recognize a medication, question
the nurse. Make sure staff checks your identification bracelet prior to giving you medications.
Report any changes to your doctor or nurse
Your doctor and nurse need to know about any
changes in your condition or new symptoms to
help make an accurate diagnosis and assist in
managing any problems. If you feel that something has changed in your condition, alert your
caregivers. Alerting family and friends about
your condition can help them advocate for you.
They may also be able to alert medical staff to
changes in your condition.
If you feel that a caregiver has not addressed your
safety concerns, please contact the nursing unit
manager or the Patient Safety Office at 860.972.2625
or 2.2625 from any hospital phone.
• Red for allergies
• Pink for limb restrictions (wristband goes on
affected limb, all other bands are placed on
arm opposite of affected limb)
• Blue for difficult airway
• Gray for Aspiration Precautions
• No Blood CBMS Patients (bloodless medicine)
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Rest
Keeping it quiet
Our HUSH (Help Us Support Healing) campaign
was designed to keep the hospital as quiet as
possible to support healing.
Getting adequate rest is an
important part of your recovery.
We make every effort to ensure
your comfort by minimizing noise.
However, some unavoidable
sounds that may occur include:
•Moving furniture/equipment
H.U.S.H.
Help Us Support Healing
Let’s work together to help keep
patient care areas quiet.
Hartford Hospital is a
QUIET
ZONE
•LIFE STAR helicopter
•Emergency overhead pages
•Medical equipment hums, beeps or alarms
Please let us know of noises that are disturbing
your rest and we will try to address the source
and correct the problem in a timely manner.
If we cannot eliminate the noise, we will
explore ways to reduce it.
Feel free to ask for earplugs, an eye-masks
and/or TV headphones for your comfort.
Your Nutrition
Patient meals
Caring Cuisine is our dining service for patients.
Food and nutrition is very important to your
health and healing. You will be visited each day
by a food service coordinator who will help you
make menu selections based on your personal
preferences and the nutrition plan prescribed
by your physician. You may speak to Food and
Nutrition Services at 2.3663 between 6 a.m.
and 7 p.m.
Fall Prevention:
Staying Safe
To prevent a fall:
•Wear the double-sided grip slippers or
non-skid shoes when out of bed.
•Notify staff immediately if any fluid is
spilled on the floor.
•Change position slowly when getting out of
bed and wait a few moments before walking
away from the bed or chair.
•Be aware of any tubes, drains, or equipment
attached to your body that might cause you
to trip.
•Do not use mobile objects such as IV poles,
over-bed tables or unlocked wheelchairs to
steady yourself.
•Request assistance with walking or getting up
if you feel weak, dizzy, tired, or uncertain of
your ability.
•Notify the staff immediately if you almost fall,
but catch yourself.
Your nurse assesses your risk of falling when
you are admitted to the hospital and then at
least daily.
Fall precautions:
If it is felt that you are at high risk of falling,
you will be placed on the hospital’s fallprevention protocol. A triangle will be placed
outside of your room and on your stretcher
when in transit. A bracelet will be placed on
your wrist. An exit alarm will be set.
•Never get up from the bed or chair without
staff assistance. Call before you fall.
•Allow a staff member to remain with you
while you are in the bathroom as this is where
many serious falls occur.
•Never turn off your bed or chair alarm.
•Do not sit on the side of the bed as you may
slip off; request that staff assist you to a
chair instead.
8
A Guide for Patients, Family & Healthcare Providers
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Mobility is Medicine:
Keeping You Moving
Effects of extended bedrest
Staying as active as possible while you are in
the hospital is important to your health and
function.
Studies show that bed rest increases your risk
for many preventable conditions such as pressure sores, constipation, pneumonia, blood clots
and low blood pressure that can make you dizzy
when you come to standing. It causes weakness
and fatigue that can result in a decline in function, putting you at risk of falling and making
you more likely to need a rehabilitation facility
upon discharge from the hospital.
• If you need help to mobilize, you may be
assisted by unit staff, rehabilitation specialists, or trained mobility volunteers. Special
equipment may be needed to help keep you
and our staff safe as we help you move.
• We encourage you to walk with family
members but only if it has been determined
by staff to be safe.
Lying in bed for prolonged periods can make
you feel more tired and not eager to get out of
bed. Small amounts of activity throughout the
day are a great way to start. Each day try to
do a little more.
If you need help to walk do not feel like you
are bothering staff by asking if someone will
walk with you. Mobility is Medicine – Just as
you would ask for medicine if you had a
headache, look at getting up and moving as
medicine for many parts of your body!
Keeping You from Harm:
Preventing a Blood Clot
Progressive mobility while in the hospital
To help build or maintain your strength, balance
and endurance it is important that you take
advantage of every opportunity to move during
your hospital stay. Our staff will help you do
this through our progressive mobility program:
• Each day your nurse or therapist will choose
the level of activity that is appropriate for
you and your condition. These levels may
include:
0Bedrest
1 Sitting fully upright (supported)
2 Sitting at the edge of the bed
3 Practicing standing at the side of the bed
4 Transferring to a bedside chair
5Walking
• Along with your medications, tests, and
treatments, mobility expectations will be
included in your daily plan of care.
Hospitalized patients are at increased risk of
developing blood clots in their legs that can lead
to more serious problems. Walking frequently
and pumping your ankles while in bed are
things you can do to improve your circulation
and lessen your chance of this happening. Some
patients may require compression devices that
wrap around the legs and apply a gentle
squeeze that helps to keep the blood in your
legs moving. You can help yourself by allowing
the staff to put these on your legs when recommended. You may also be given low-dose blood
thinners to lessen the chance of blood clots
forming while you are in the hospital. Your
participation in this care is important.
Protecting Your Skin
Skin injury can occur as a result of many factors
associated with illness or surgery. Fortunately,
you can lower your risk of skin injury by working together with your care team in the
following ways:
• While in bed, change your position (turn side
to side) every 2 hours. The team will assist
you if you are unable to turn on your own.
• While in a chair, shift your weight slightly
every hour to relieve pressure.
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• All of our mattresses are made of special
pressure reducing foam. You may require a
special air mattress, chair cushion or heel
elevation if you are at higher risk.
• Eat a balanced diet to maintain healthy skin
and heal wounds.
• A barrier cream or spray and special underpads may be used to protect your skin from
urine, stool or drainage.
• Ask questions about your treatments and
therapies so you understand them better.
Pain Management: Keeping
You Comfortable
If you are in pain or discomfort, please tell us.
We want to help you to feel comfortable. Good
pain control takes a partnership between you
and your caregivers. Managing your pain will
help you recover more quickly.
We may not always be able to take all your
pain away, but we usually can help to make it
tolerable. Your caregivers will work with you
to develop a pain relief plan. The plan may
include pain medicine. Usually pain medicine
is given as needed, so please ask your nurse
if you feel you need it. The goal of the pain
relief plan is for you to do things that will help
you get better, such as taking a deep breath or
going for a walk. Other goals include: changing you from intravenous pain medicine to
pills you can take as you transition your care
from the hospital to home or a rehabilitation
center. And for you to take pain medicine less
often as you get better. Please tell your nurse
if have any side effects from pain medicine
like nausea, itching, constipation or drowsiness. Less medicine throughout the day, as you
get better, will decrease most side effects.
Pain Scale (0 – 10)
0
10
1-2
3-4
5-6
7-8
9-10
Pain is
present
but does
not limit
activity
Can do
most
activities
with rest
periods
Unable to
do some
activities
because
of pain
Unable to
do most
activities
because
of pain
Unable to
do any
activities
because
of pain
A Guide for Patients, Family & Healthcare Providers
Your caregivers may also use other types
of pain control like heat, ice, or assisted
mobility. What works well for one person,
may not work for another. So please tell
us what has worked in the past for you.
Your nurse will assess you to be sure your
pain relief plan is working. One way to do
that is to ask you about your pain intensity
level, based on a 0-10 scale (see chart), before
and after an intervention for pain (such as pain
medicine or an ice pack). Please let your nurse
know what your own “comfort-function goal”
is – the number where your feel comfortable
enough to function. When you feel the pain
intensity is higher than your comfort-function
goal, we will try to help you feel better.
Delirium Awareness
Delirium is an abrupt change in thinking and is
common during hospitalization especially for
individuals with the following risk factors:
• age 65 or older
• dementia, stroke or head injury
• experience of delirium during previous
hospitalizations
• a severe illness requiring ICU care.
Please speak up if you or your hospitalized
family member is experiencing a change in
thinking or behavior. The symptoms that
may occur are:
• thinking different from normal for that person
• fluctuating states of awareness (excessive
sleepiness, restlessness/agitation; periods
of normalcy)
• difficulty paying attention or focusing
• confusion and/or memory loss
• paranoia, suspiciousness or hallucinations.
You know yourself best, as do the people who
are closest to you. Delirium can be related to a
medication reaction or new medical condition
that needs attention. Once identified, your
healthcare team will begin the process to determine the possible causes for the change and
start appropriate treatment. Our goal is to keep
you safe, comfortable and functional until
the delirium resolves.
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Providing patients with basic care needs can
prevent some episodes of delirium. If you
are visiting a patient who is at high risk for
delirium there are things you can do to partner with the healthcare team. You can help by
routinely offering food and drink if allowed,
walking frequently with your loved one and
keeping them involved in current events.
Feel free to share with our team individual
things that will help us to understand the
person your loved one was prior to becoming ill. If your loved one is not able to speak
for themselves be sure to fill out a “Hartford
Healthcare Cares About Me” poster to help us
personalize your loved one’s care plan.
Hartford HealthCare
Cares About Me…
I like to be called:
What I do or used to
do for work:
What I do for fun
and activity:
My favorite TV shows,
music, books are:
When a patient is identified with one of these
types of bacteria or viruses, certain precautions may be instituted to be sure they are
not transferred to others.
A sign will be posted by the entrance to
the room to identify the type of protective
equipment to be worn in the patient’s room.
It might instruct the caregiver to wear a
mask, gown or gloves depending on the best
way to stop the bacteria or virus from traveling. Hands must be washed before and after
the equipment is worn.
Help us stay true to our word – please remind
us if we should ever forget to perform hand
hygiene.
If you or your family has questions or concerns,
please do not hesitate to call Infection Control at
860.972.0321 or 2.0321 from any hospital phone.
My family, friends, pets names are:
My favorite food:
I brought with me:
Dentures: No / Yes: Upper / Lower / Both
Glasses: No / Yes
Hearing Aides: No / Yes: Right / Left / Both
HHC-C-7745 Apr15
Infection Prevention
and Control
Hand hygiene
Hand hygiene is the cornerstone of every
infection prevention and control program.
It is the first and foremost way to prevent
infections, and is taken very seriously at
Hartford Hospital. Every caregiver has
taken a pledge to perform hand hygiene.
Hand hygiene may be accomplished by using
good old fashioned soap and water, or Purell®
waterless hand sanitizer. All caregivers at
Hartford Hospital are expected to perform
hand hygiene before and after every patient
encounter. Patients and visitors should also
perform hand hygiene before eating, after
using the bathroom or when entering or
exiting the patient’s room. Hand hygiene
removes bacteria and viruses and prevents
them from being transferred to you, your
loved ones, other patients or caregivers.
Transmission-based precautions
Certain bacteria or viruses are spread easily
from person to person and are easily transferred to the environment or equipment by
an infected person. Depending on the type
of bacteria or virus, they can be spread
through the air by coughing or sneezing,
by equipment or hands.
Integrative Medicine
Integrative medicine is a division of the Cancer
Center with hospital-wide and community
services. Integrative medicine, which offers
compassionate care to heal the mind, body and
spirit, integrates alternative/complementary
therapies into Western medical practice. It provides pain management and relaxation without the use of medications to improve care and
healing. You may find an intervention such as
reiki, massage, guided imagery or acupuncture
beneficial. For more information, please visit
www.harthosp.org/intmedclasses, e-mail
[email protected] or call 860.545.1888.
Palliative Medicine
Palliative Medicine is specialized medical care
for people with serious illness. This type
of care is focused on providing patients with
relief from the symptoms, pain, and stress of
a serious illness – whatever the diagnosis.
The goal is to improve quality of life for both
the patient and the family.
Palliative care, provided by a team of doctors,
nurses, social workers and other specialists, is
appropriate at any age and at any stage in a
serious illness.
Palliative medicine requires an order from
your attending physician. Feel free to ask your
healthcare team or your doctor to request
a consult.
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Interpreter Services
Hartford Hospital provides interpretation
services for deaf, hearing-impaired and limited
English speaking patients and their families
to help them understand and be understood
during hospitalization.
We use outside agencies, trained employee
interpreters, video conferencing interpreters,
and the Language Line, which provides access
to phone translation 24 hours a day, seven
days a week. Contact your nurse to arrange
for an interpreter.
If you have any questions or concerns, please contact Patient Relations at 860.972.1400 or extension
2.1400 from any hospital phone.
Deaf and Hearing
Impaired Services
To ensure effective communication with
patients and their companions who are deaf
or hard of hearing, we provide appropriate
auxiliary aids and services free of charge,
including:
• Sign language
Spiritual Care
The Spiritual Care Department at Hartford
Hospital is known for honoring and providing
spiritual care as an essential dimension of
healing. Our chaplains offer spiritual care to
patients, families, and staff, responding to
each person’s unique values and beliefs.
When to Call a Chaplain
• When you or your family feels scared about
being in the hospital
• When you or your family are grieving a loss
• Oral interpreters
• When you or your family feel discouraged,
lonely, or disconnected
• Video interpreting
• When you are asking God, “Why?”
•TTYs
• When you wish to have guided meditation
• Note takers
• When you or your family are facing a
difficult decision
• Written materials
• Telephone handset amplifiers
• Assisted-listening devices and systems
• Closed captioning of most hospital
programs
Please ask your nurse or other hospital personnel
for assistance, or contact the Patient Relations
Department at 860.972.1400 (voice) or
860.545.2260 (TTY).
Ethics Committee and
Ethics Consultation Service
The ethics consultation service is as a resource
for families, patients, hospital staff and
physicians in addressing the often difficult
medical-ethical issues in healthcare.
12
The ethics consultation service attempts to
clarify and resolve ethical dilemmas arising
in the course of patient care. The values and
preferences of patients and their surrogate
decision makers are respected and balanced
with the best medical judgments determined
by physicians to resolve ethical dilemmas.
Any employee, patient, family member or
representative of Hartford Hospital may
contact the ethics consultation service at
860.825.9685.
A Guide for Patients, Family & Healthcare Providers
• When you want to receive sacraments, a
blessing or other ritual
• When you or your family want someone to
join you in prayer
• When you are adjusting to a new diagnosis,
treatment or medical event
• When you are waiting for news
• When you or your family need help
contacting your Pastor, Rabbi, Imam or
Faith Community
• When you or your family would like to add a
prayer request to our noontime prayer service.
If you wish to speak with a chaplain please
talk with the staff or call 860.972.2251 to
request an appointment. Facing illness or
watching a loved one struggle during a
hospitalization can be very challenging.
Talking to a chaplain can help if questions
or concerns arise. We hope to support you
during your time here.
You r S tay At H a rt for d Hospi ta l
Lazowski/Keily Multifaith Chapel
The Multifaith Chapel is located on the first
floor of the hospital by the gift shop and is
always open for prayer or meditation. There
is a space in the chapel for Muslims to pray.
Prayer requests can be added on the bulletin
board outside the chapel, or by calling
your chaplain.
On weekdays from 12:00-12:15, our chaplains
will lift up the prayers of the community.
Please join us for this service of meditation
and reflection. On Sundays at 3:45 pm a priest
celebrates Roman Catholic Mass. All of these
services are broadcast throughout the hospital
on Channel 17.
Organ and Tissue Donation
To learn more about organ and tissue donation
and how you can become a registered donor,
please call LifeChoice Donor Services at
1.800.874.5215 or visit: www.lifechoiceopo.org
or www.donatelifenewengland.org.
Preparing to leave
the Hospital
Your care team will already be planning
for the day you are ready to go home, or to
another facility, within the first 1-2 days of
admission. You’re an important member of
this care team. We will keep you informed as
to your discharge date and time and we will
make every effort to facilitate your discharge
before 11am.
Your Case Coordinator will assist you with
choosing a home health agency, a skilled
nursing facility, or rehabilitation hospital as
determined to be necessary for your successful transition from Hartford Hospital.
Understand your discharge instructions.
It is important that you fully understand
your discharge plan to ensure your continued
healing, safety, and comfort. You will receive
these instructions in writing. Before you
leave the hospital ask questions about all of
your medications, and be sure you know
what medications are being prescribed, the
proper dosage, how and when to take the
medication, and possible side effects.
Be informed about your health condition
(ask the care team if you do not understand
any information shared with you) and what
you can do to help yourself get better.
Your instructions should also include when you
should schedule follow-up appointments with your
primary care physician and/or other specialists.
Clinical Progression Rounds
These are rounds that occur every day on
every nursing unit. The primary goals of these
rounds are to enable the provision of care in
a more standard and efficient manner, and
enhance the patient and family experience
through improved coordination and communication within the care team. Each patient’s
progress towards recovery is reviewed,
and any barriers to a timely transition are
addressed. Our commitment to you is to work
very hard to provide you with timely service
and prevent any delays in your being able to
go home or to another facility. Each day we
will provide you with an updated Care Plan
that will include your anticipated date of discharge, current diet, activity, daily goals, and
a list of your medications. Ask questions about
your care plan, talk about treatment options,
and most importantly, make sure your wishes
are made known to our care team.
Retrieve all of your personal belongings
Please collect all personal belongings. If you
have a pink voucher that shows you have
valuables stored in our hospital safe, please
let your nurse or PCA know so that they may
be retrieved. You may call the Cashier’s Office
at 860.972.2119 or 2.2119 from any hospital
phone to check if you have anything of value
in the safe.
Lost & Found
If your belongings are missing, please contact
the Lost & Found at 860.972.5678 (LOST).
If something of value is missing, please contact
the Security Department at 860.545.2147.
Hartford Hospital is not responsible for belongings and
valuables or personal items kept in the patient’s possession during admission.
Hartford Hospital is not responsible for replacing
electronic devices such as cell phones, iPads or laptops.
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Your Opinion Counts
Hospital Consumer Assessment of Healthcare
Providers and Systems (HCAHPS®) is a national,
standardized survey of hospital patients.
HCAHPS (pronounced H-caps) was created to
publicly report patients’ perspectives on
11 important measures of hospital care.
The HCAHPS survey allows consumers to
make fair and objective comparisons between
hospitals on topics such as coordination of
care, communication, cleanliness and
discharge information.
You may receive a survey at home by mail
within 30 days after leaving Hartford Hospital.
If you receive a survey, we hope that you will
participate. Your anonymous feedback helps us
identify our strengths and also tells us where
you think we can improve.
Patient Financial Services
About your bill
We make every effort to obtain insurance and
financial verification. You or a family member
may wish to contact your insurance company
for guidance (your insurance card will tell
you how to contact member services).
Our patient financial services office can
be reached at 860.696.6010 or toll-free at
1.888.515.5544 from 8 a.m. to 5 p.m., Monday
through Friday. Credit card payments are
accepted over the telephone or at our cashier
window, Monday through Friday, 8 a.m. to
4 p.m. Payment of non-covered charges,
deductibles and co-insurance may be paid by
cash, check or credit cards including MasterCard®, VISA®, Discover®, and/or American
Express®.
Prior to, or while a patient at Hartford Hospital,
you may be contacted by a financial counselor
to obtain additional information, complete
paperwork, or discuss payment arrangements
or assistance.
If you have any concerns regarding payment,
we urge you to contact one of our financial
counselors:
• Prior to admission: 860.972.2730
• During your admission: 860.972.2820,
860.972.4056 or 860.972.4617
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A Guide for Patients, Family & Healthcare Providers
Financial assistance
Consistent with our mission, Hartford Hospital
provides medical care regardless of a patient’s
ability to pay. We make financial assistance
available to qualified uninsured or underinsured patients. If you are not able to pay for
all or part of your care, please inform the
registrar, financial counselor, social services
department or patient accounts office, and ask
about the availability of financial assistance.
Donated funds
Additionally, Hartford Hospital has donated
funds available for medical care. Funds are
awarded to individuals with limited means
who meet the eligibility requirements.
Each fund has criteria for selecting eligible
participants.
Please request an application from anyone
in the registration office or call one of the
following departments:
• Social services: 860.972.2966
•Patient accounts: 860.696.6010
• Toll free: 1.888.515.5544
Once the hospital reviews your application,
you will be notified in writing of the result.
If your application is rejected, you may reapply
as additional funds may become available on
a yearly basis or your financial circumstances
may change.
Fa m i ly & V isi t or s
The Gift Shop
ATM Machines
Hartford Hospital’s Auxiliary Store, located
on the first floor, adjacent to the main lobby,
offers a wide variety of items for patients,
families and staff. All proceeds benefit the
programs and services of Hartford Hospital.
Call 860.972.2155 or extension 2.2155 from any
hospital phone for additional information.
ATMs are located on the ground floor of the
Bliss Wing, next to the cafeteria and in the
Auxiliary Gift Shop, first floor.
Items available include:
• Magazines, newspapers, paperback books,
crossword puzzle books
• Greeting cards, postcards, boxed stationery,
address books, pads, pens and envelopes
• Flowers, balloons, gifts and jewelry
• Beverages and snacks
Dining Services for Visitors
Hartford Hospital’s cafeteria is on the ground
floor of the hospital’s Bliss wing
Hours:
Breakfast
6:25 a.m. to 10:30 a.m.
Lunch
11:00 a.m. to 2:00 p.m.
Afternoon Snack
2:00 p.m. to 4:00 p.m.
Dinner
4:30 p.m. to 8:00 p.m.
Patient CareGrams
A Patient CareGram is a free service that
allows you to send a greeting to a friend or
loved one who is currently a patient at
Hartford Hospital. You can customize your
CareGram and it will be printed and delivered
the next business day. If the patient has been
discharged it will be mailed. (Please note that
patients who have opted out of the hospital
directory will not receive CareGrams during
their stay, but messages will be mailed to
their home address.)
You can also send an electronic message
to a patient using your own e-mail program
that will be printed and delivered. Please
include the patient’s full name, and if
possible, the patient’s location. We reserve
the right to refuse delivery of any messages
and/or images deemed inappropriate. Contact
Patient Relations at 860.972.1400 or extension
2.1400 from any hospital phone for more
information.
Au Bon Pain is located in the main lobby
24 hours a day/7 days a week
ERC (Education Resource Center) is located
on Hudson Street.
Vending/Snack Area open 24 hours.
H a rt for d Hospi ta l15
Fa m i ly & V isi t or s
Lodging (Hudson Suites)
Hotel Accommodations
On-campus accommodations
Hudson Suites at Hartford Hospital,
560 Hudson Street (3rd floor), Hartford, CT
06102. Call 860.545.1111 or 1.877.979.9997
for reservations.
Marriott Downtown
200 Columbus Boulevard
Hartford, CT
860.249.8000
Hudson Suites are perfect for patients
undergoing an early morning procedure or
for family members wanting to be nearby a
patient. Twelve suites are available to the
hospital’s patients and their families for
overnight and short-term stays at a modest
cost. All suites have a sleeping area with a
double bed, a sitting area and a pull-out sofa.
• There is a $55.00 charge per room, per night.
• We do not require a deposit, but we do
require that a credit card be on file.
There is no cancellation fee.
• All major credit cards, cash and personal
checks are accepted.
• Secured parking is available at a small
additional cost. The security guard at the
desk will direct you to the hospital garage.
• Check-in time is 2 p.m. to 11 p.m.; other
times by special arrangement.
• Check-out time is 11 a.m., or later by
special arrangement.
We are not able to make baby-sitting arrangements and children may not be left alone in
the rooms. We regret we cannot accommodate pets; service dogs (for a person’s handicap)
are allowed in the Suites.
For more information or directions to the Hudson
Suites, call 860.545.1111 or toll free 1.877.979.9997.
16
A Guide for Patients, Family & Healthcare Providers
Located .9 miles from Hartford Hospital
Homewood Suites by Hilton Hartford
Downtown
338 Asylum Street
Hartford, CT
860.524.0223
Located .9 miles from Hartford Hospital
Holiday Inn Express HARTFORD - DOWNTOWN
440 Asylum Street
Hartford, CT
860.246.9900
Located .9 miles from Hartford Hospital
Residence Inn Hartford Downtown
942 Main Street
Hartford, CT
860.524.5550
Located 1 mile from Hartford Hospital
Hilton Hartford
315 Trumbull Street
Hartford, CT
860.728.5151
Located 1.1 miles from Hartford Hospital
Radisson Hotel Hartford
50 Morgan Street
Hartford, CT
860.549.2400
Located 1.2 miles from Hartford Hospital
W h at E ve ry Pat i en t N ee ds to K now
References
Patient Privacy
•Non-discrimination
Notice of Privacy Practices
•Patient Privacy
Privacy of patient information
We comply with the Health Insurance
Portability and Accountability Act (HIPAA)
and keep information about you confidential.
•Patient Rights and Responsibilities
• Your Rights Concerning Medicare
• Hartford Hospital is an Academic
Medical Center
• Medical Records
Non-discrimination
In accordance with federal regulations,
Hartford Hospital does not exclude, deny
benefits or otherwise discriminate against
any person on the grounds of age, gender,
race, ethnicity, religion, culture, language,
socioeconomic status, sexual orientation,
gender identity or expression, physical or
mental disability, in the admission to,
participation in, or receipt of the services and
benefits of its programs and activities. You
may contact Hartford HealthCare Office of
Compliance, Audit & Privacy at 1.855.HHC.
OCAP for further information about these
regulations and our procedure for the
resolution of discrimination complaints.
Hartford Hospital’s responsibilities
The hospital receives and generates information about you which is deemed protected
health information (PHI). We must inform
you of the ways in which your PHI will be
used and/or disclosed in the Notice of
Privacy Practices.
The following summarizes your rights contained
in the notice. You have the right to:
• Receive the notice of Hartford Hospital’s
privacy practices.
• Request a restriction of the use and/or
disclosure of your PHI.
• Opt out of our facility directory, thereby
requiring us to not acknowledge that you
are here at Hartford Hospital to anyone in
the public who may ask for you.
• Access your PHI.
• Request an amendment to your PHI.
• Complain if you feel your privacy rights
have been violated.
The hospital is required to notify you if we
cannot abide by a requested restriction on
how your information is used or disclosed.
If you have further questions or concerns about
your PHI contact a patient advocate through the
Patient Relations Department at 860.972.1400 or
2.1400 from any hospital phone.
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W h at E very Pat i en t N ee ds to K now
(See full details in our Notice of Privacy Practices.)
Patient Rights
As a patient at Hartford Hospital, you have
the right to:
• Make informed decisions.
• Considerate and respectful care in a safe,
comfortable environment.
• Personal privacy and confidentiality.
• Be treated with dignity.
• Have your physician and a family member
or other person of your choice notified of
your admission to the hospital.
• Create an advance directive.
If you are not satisfied with the outcome
of your grievance contact the following
agencies:
Connecticut Department of Public Health
410 Capital Avenue
Hartford, CT 06134-0308
Phone: 860.509.7400
1.800.842.0038
TTY:860.509.7191
www.ct.gov/dph
• Treatment by compassionate, skilled,
qualified health professionals.
The Joint Commission
One Renaissance Boulevard
Oakbrook Terrace, IL 60181
Phone: 1.800.994.6610
www.jointcommission.org
• Be informed about and participate in your
care and treatment plans.
Patient Responsibilities
• Know the names of healthcare providers
and their role in your care.
• Be free from seclusion and chemical or
physical restraints of any kind that are
not medically necessary, using the leastrestrictive effective approach.
• Be free from all forms of abuse or
harassment.
• Request medically appropriate and
necessary treatment.
As a patient at Hartford Hospital, these are
your responsibilities:
• Give us complete information about your
medical history, including any medications
you may be taking.
• Tell us what you need. If you do not understand your care plan, ask questions.
• Refuse treatment as allowed by laws.
• Be part of your care. It is important for you to
tell us how you want to partner in your care.
• Know what safety measures may be used
during your care.
• If you are not satisfied with your care,
please tell us how we can improve.
• Ask for a second opinion about your care.
• Follow our guidance in helping you get well.
• Proper assessment and m
­ anagement of
your pain or discomfort.
• Be considerate of the rights of other
patients, families and hospital personnel.
• Request an interpreter.
For questions or more information about your
Rights and Responsibilities, contact Patient
Relations at 860.972.1400 or extension 2.1400
from any hospital phone.
• Review and obtain copies of your
medical records.
• Receive treatment in an environment that is
sensitive to your beliefs, values and culture.
• Be informed about the care you will need
after discharge.
• Receive information about, and an explanation of, your hospital bill.
• Request that an autopsy be performed here
or arrange for another institution of your
choice to perform it.
18
• Express a complaint or grievance by
contacting the Patient Relations Department
at 860.972.1400 or extension 2.1400.
A Guide for Patients, Family & Healthcare Providers
W h at E ve ry Pat i en t N ee ds to K now
Your Rights Concerning
Medicare
As a hospital inpatient you have the right to:
•Receive Medicare covered services.
This includes medically necessary hospital
services and services you may need after
you are discharged, if ordered by your
Doctor. You have a right to know about
these services, who will pay for them,
and where you can get them.
•Be involved in any decisions about your
stay and know who will pay for it.
•Report any concerns you have about the
quality of care you receive to the Quality
Improvement Organization (QIO):
– Name of QIO: Livanta
– Telephone Number of QIO: 1-866-815-5440
Planning for your transition from the hospital:
During your hospital stay, your care team will
be working with you to prepare for your safe
transition and arrange for services you may
need after you leave the hospital. When you no
longer need inpatient care, your Doctor or the
hospital staff will inform you of your planned
discharge. If you have concerns, talk to your
doctor, a representative of your plan, your Case
Coordinator, or any member of your care team.
Medicare appeal rights
You have the right to ask for a review of the
discharge decision by the Beneficiary and
Family Centered Care Quality Improvement
Organization (BFCC-QIO) before you leave.
A BFCC-QIO is a type of quality improvement
organization (a group of doctors and other
healthcare experts under contract with
Medicare) that reviews complaints and quality
of care for people with Medicare. Information
regarding your Discharge Appeal Rights has
been provided to you (Important Message
From Medicare) which contains information
on your BFCC-QIO. If you don’t get this notice,
please ask for it. For more information you
may call Medicare toll free/24 hours a day at
1.800.MEDICARE (1-800-633-4227). TTY users
should call 1-877-486-2048.
Your right to an immediate appeal without
financial risk: If you think you are being asked
to leave the hospital too soon when advised of
your planned date of discharge, you have the
right to appeal to your Quality Improvement
Organization The QIO is authorized by
Medicare to provide a second opinion about
your readiness to leave.
Patients’ Rights from the Centers for Medicare
and Medicaid (CMS) Services - §482.13
Condition of participation
Hartford Hospital is committed to providing
all patients with the opportunity to express
dissatisfaction in accordance with §482.13(a)
(2), as stated in the Conditions of Participation
under Patients’ Rights from the Centers for
Medicare and Medicaid Services. The law and
regulations may be examined at the Patient
Relations Department, 80 Seymour Street,
Hartford, CT 06102, 860.972.1400, which has
been designated to coordinate the efforts
of Hartford Hospital to comply with the
regulations.
• A complaint is an issue that is easily solved
by staff present or anyone who can quickly
be at the patient’s location while the patient
is still in the hospital. For example, the staff
may request a nursing supervisor, patient
advocate or another administrative member
of the staff to assist in resolving the issue.
• A grievance is a written complaint by a
patient or the patient’s representative
regarding the patient’s care, abuse or
neglect, issues related to the hospital’s
compliance with CMS’ Hospital Condition
of Participation, or a Medicare beneficiary
billing complaint related to rights and
limitation.
A written acknowledgement of all grievances
will be made to the person filing it within
seven business days. If the grievance is still
under investigation after seven business
days, an estimated time for final response
will also be communicated to the complainant with the written acknowledgement of
receiving the grievance. Periodic communication will continue if the resolution takes
longer than 30 days.
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W h at E very Pat i en t N ee ds to K now
The patient, or the patient’s representative,
has the right to file a complaint with the
State of Connecticut, Department of Public
Health, 410 Capitol Ave., Hartford, CT 06134.
Telephone number: 860.509.7400,
1.800.842.0038 or TTY: 860.509.7191 at
any time.
The patient, or the patient’s representative,
has the right to file a complaint with the
Joint Commission on their website:
www.jointcommission.org; through e-mail:
[email protected]; by writing
to the Office of Quality Monitoring, The Joint
Commission, One Renaissance Boulevard,
Oakbrook Terrace, IL 60181; or by calling
1.800.994.6610.
Hartford Hospital is an
Academic Medical Center
Hartford Hospital is an academic medical
center and major teaching affiliate of the
University of Connecticut School of Medicine,
responsible for training the next generation
of physicians.
Hartford Hospital attracts top physicians
who are committed to academic and medical
excellence through their role as members
of the hospital’s teaching faculty. Keeping
abreast of the latest medical developments
and the most advanced technology are two
benefits of our role as a respected teaching
hospital.
Our academic medical center prepares medical graduates for practice in many accredited
programs, including anesthesiology, cardiology, general surgery, internal medicine,
obstetrics-gynecology, pathology, pediatrics,
and radiology. Graduate medical education is
the final phase of training for physicians who
have successfully completed medical school.
Teaching hospitals are the heart of graduate
medical education. Attending physicians
provide supervised training and guidance for
the medical school graduates, also known as
resident physicians, in a hospital setting.
20
A Guide for Patients, Family & Health Care Providers
Providing round-the-clock physician care
Resident physicians, in training, function
as part of the healthcare team to deliver
the highest quality patient care under the
supervision of practicing physician teachers.
Upon your arrival, your resident physician,
under the guidance of your physician, will
review the history of your current illness and
past medical history. A physical examination
will be performed to substantiate previous
findings and evaluate changes. Some of the
questions and procedures may seem repetitive, particularly given the anxiety that
comes from being hospitalized. Be assured
that the resident is acting in your best
interest, as an essential member of your
healthcare team. Your resident physician will
be in close touch with your physician to provide updates on your condition. Frequently,
this new information on your progress will
speed your recovery. While the resident
physician may not be able to answer all of
your questions immediately, he or she
will respond as soon as possible. Please
remember that laboratory test results and
consultations need to be evaluated by our
attending physician, who has ultimate
responsibility for your care.
Medical Records
(Health Information Management)
As a patient, you have the right to a copy of
your medical record. In order to receive a
copy of your record or to have a copy of your
record sent to a third party, you are required
to put your request in writing on a valid
authorization form (you can not simply tell
someone). In some instances, there is a
per-page fee for copies of medical records.
The Medical Records Department is located on the
first floor of Hartford Hospital in room 139. You
may also contact them by phone at 860.972.4764
to complete an authorization to disclose form.
Receiving a copy of your medical record may
take up to 30 days.
Patients can visit the following website for
instructions and to print forms
www.harthosp.org/medicalrecords
Date
Notes, Questions and /or Instructions
H a rt for d Hospi ta l21
Date
22
Notes, Questions and /or Instructions
Healthcare
A Guide for Patients, Family & Health
CareProviders
Providers
HHC-C-8750 Aug15
APPOINTMENT OF HEALTH CARE REPRESENTATIVE
I understand that, as a competent adult, I have the right to make decisions about my health
care. There may come a time when I am unable, due to incapacity, to make my own health
care decisions. In these circumstances, those caring for me will need direction and will turn
to someone who knows my values and health care wishes. By signing this appointment of
health care representative, I appoint a health care representative with legal authority to
make health care decisions on my behalf in such case or at such time.
I appoint ___________________________________ to be my health care representative.
If my attending physician determines that I am unable to understand and appreciate the
nature and consequences of health care decisions and to reach and communicate an
informed decision regarding treatment my health care representative is authorized
make any and all health care decisions for me, including the decision to accept or
refuse any treatment, service or procedure used to diagnose or treat my physical or
mental condition and the decision to provide, withhold or withdraw life support
systems, except as otherwise provided by law which excludes for example psychosurgery
or shock therapy.
I direct my health care representative to make decisions on my behalf in accordance with
my wishes as stated in a living will, or as otherwise known to my health care representative.
In the event my wishes are not clear or a situation arises that I did not anticipate, my health
care representative may make a decision in my best interests, based upon what is known
of my wishes.
If ________________________________ is unwilling or unable to serve as my health care
representative, I appoint ____________________________________ to be my alternative
health care representative.
This request is made, after careful reflection, while I am of sound mind.
______ / ______ / ______ (Date)
X______________________________
WITNESSES' STATEMENTS
This document was signed in our presence by _____________________________ the author of
this document, who appeared to be eighteen years of age or older, of sound mind and able to
understand the nature and consequences of health care decisions at the time this document was
signed. The author appeared to be under no improper influence. We have subscribed this
document in the author's presence and at the author's request and in the presence of each
other.
x__________________________
(Witness)
x__________________________
(Number and Street)
x__________________________
(City, State and Zip Code)
x___________________________
(Witness)
x___________________________
(Number and Street)
x___________________________
(City, State and Zip Code)
H a rt for d Hospi ta l23
OPTIONAL FORM
WITNESSES' AFFIDAVITS
STATE OF CONNECTICUT
COUNTY OF ____________________________
)
)
)
)
)
:ss.__________________________
(Town)
We, the subscribing witnesses, being duly sworn, say that we witnessed the execution of this
appointment of a health care representative by the author of this document; that the author
subscribed, published and declared the same to be the author's instructions, appointments and
designation in our presence; that we thereafter subscribed the document as witnesses in the
author's presence, at the author's request and in the presence of each other; that at the time of
the execution of said document the author appeared to us to be eighteen years of age or older,
of sound mind, able to understand the nature and consequences of said document, and under
no improper influence, and we make this affidavit at the author's request this _____ day of
_____________________, 20____.
x_____________________________
(Witness)
x_____________________________
(Number and Street)
x_____________________________
(City, State and Zip Code)
x_______________________________
(Witness)
x_______________________________
(Number and Street)
x_______________________________
(City, State and Zip Code)
Subscribed and sworn to before me by ___________________and ______________________,
the signing witnesses to the foregoing affidavit this ______ day of _________________,
20____.
_________________________________
Commissioner of the Superior Court
Notary Public
My Commission expires: _____________
(Print or type name of all persons signing under all signatures)
24
A Guide for Patients, Family & Healthcare Providers
Quick Reference Notes:
Nursing Unit
Patient Relations
Guest Services, Compliments, Concerns,
2.1400
General Questions
Patient Room
Room phone will be off from 10 p.m. – 8 a.m.
Meal Times
Breakfast:Lunch: Dinner:
To place a call within Hartford Hospital: Pick up
the handset and dial the five digit extension number
(or the last five numbers of any internal phone number).
If you are having difficulty with your phone, please
dial 0 to speak to an operator, or inform your nurse.
ServiceExtension
Cashiers Office
Valuables
2.2119
Chaplain2.2251
Hartford HealthCare Office of Compliance, Audit & Privacy
1.855.HHC.
OCAP
Case Coordination
2.1475
Food & Nutrition
2.3663 (FOOD)
Gift Shop
2.2155
Health Referral Service
5.1888
Hudson Suites 5.1111
On-campus Accommodations
Integrative Medicine
2.4444
Massage, Guided Imagery, Acupuncture
Interpreters
2.1400
Deaf & Foreign Languages
Lost & Found
2.5678
Medical Records (option 4)5.4764
Pastoral Services 2.2251
Patient Accounts
2.2706
Patient Information
2.2711
Security5.2147
Social Work Service
Volunteer Services 2.2966
Book Cart, Reiki, Pet Therapy, Art for Healing
2.2198
Care Giver Identifier Program
Our clinical staff wear specific color-coded uniforms
Registered Nurse
RN
Technician
Examples include:
• Patient Care Assistant
• Medical Assistant
• Dental Assistant
• Radiology Technician
CESI
Phlebotomist
Rehab
Respiratory
Therapist
Research
Unit Aide
Technologist
Pharmacy
Technician &
Examples include:
• MRI Technologist
• Nuclear Medicine
• Technologist
• Radiation Therapist
• Mammography Technologist
• Cat Scan Technologist
• UltraSonographer
• Dental Hygienist
Equipment
Technician
Television Service
Hospital television service provided by
Allen Technologies, Inc.
TV channel listings
4COZI
35CNN
46ESPNEWS
5
36 FOX News Live
47ESPNU
6WCCT
37HLN
48BET
7
38TBS
49 Spanish Channel
10NBC
39 Weather Channel
50Univision
11ABC
40TNT
51 History Channel
12CBS
41USA
53SyFy
17Chapel/Meditation
42 Animal Planet
54 E! Entertainment
18 Newborn - Espanol
43 Discovery Channel
55HGTV
21 Newborn - English
44NESN
56 Food Network
33 Hospital Info
45ESPN
57EWTN
CPTV KIDS
FOX CT
For television related questions or issues please call extension 2.1999
from your hospital phone.
Channel listing updated 3/22/2016
Living Our Values
Hartford Hospital
VP
NORTH
Women’s Ambulatory
Health Service (WAHS)
SP
SP
Street Parking
EP
Employee Parking
High Building
8
Jefferson Building
6
1
4
VP
Capitol Ave.
State Capitol
Bushnell Park
Downtown
5 Education & Resource Building ERC
6 Emergency Department
7 Helen & Harry Gray Cancer Center
8 High Building, Main Entrance
Patient Information
15
Medical Office
Building (MOB)
SP
P1
9 85 Jefferson Street Entrance
Campus Border Tobacco-Free Area
EP
VP
7
EP
3 Brownstone Clinics
4 Conklin Building
P2
3
2
To:
2 Bliss Wing Cafeteria, ATM
Construction Zone
5
9
1Admitting
Parking for Patients & Visitors
SP
Education & Resource
Center (ERC)
EP
•
•
•
•
P
Valet Parking for Patients
Connecticut Children’s
Medical Center CCMC
EP
Emergency Dept.
Conklin Building
10
EP
30
EP
EP
16
Connecticut Children’s
Medical Center (CCMC)
13
P
19
29
25
26
EP
24
28
27
22
P
17
Braceland Building
18
EP
Medical Office Building MOB
15 Physician Offices
RestaurantOpticians
Pharmacy ATM
P
23
Burlingame
Donnelly Building
EP
IOL Center Building
20
21
12 Ambulatory Entrance
13 Main Entrance
14 Emergency Department
Gengras Building
14
12
11 South Building
Red arrows mark main entrances
11
10 Future site of Hartford HealthCare’s
Bone & Joint Institute
EP
Institute of Living IOL
16 Donnelly Building
17 Braceland Building
18 Commons Building
19 Massachusetts Cottage Building
20 Thompson Building
21 Staunton-Williams Building
22 West Grad Building
23 Todd Building
24 Center Building
25 Fuller Building
26 Butler Building
27 Olin Neuropsychiatry Center
28 Burlingame Research Building
29 Terry Building
30 Gengras Building
Hartford Hospital
Parking Pass
Options for Parking: Please refer to our map and building legend for directions to these sites.
Weekly & Monthly Rates
1. Valet parking (VP on the map) services are located on Seymour Street in the circular drive of the Weekly ($20) and monthly ($65) parking
passes are available at discounted rates
at Hartford Hospital’s cashier’s office
on the first floor, Room 136, from 8 a.m.
to 4:30 p.m.
2. Self-parking is available at the public parking garage located between Washington and Seymour
Helen & Harry Gray Cancer Center free
valet service is available at the entrance
to the Helen & Harry Gray Cancer
Center (#7 on the map) on 85 Retreat
Avenue for Cancer Center patients
only. Valet service is available Monday
through Friday from 6 a.m. to 6 p.m.
Streets (P1 on map), and conveniently attached to the Medical Office Building on 85 Seymour Street
(#15 on the map).
3. Self-parking is available at the Retreat Avenue garage on 100 Retreat Avenue (P2 on map).
Parking passes may also be purchased
at Connecticut Children’s Medical
Center’s (CCMC) cashier’s office
in Room 210, on the hospital’s
second floor.
Helen & Harry Gray Cancer
Center Valet Parking
admitting entrance, and at the Helen & Harry Gray Cancer Center for patients of that center.
Handicap Parking is located on Seymour Street in the circular drive in front of the admitting
entrance (#1 on the map), and in both parking garages.
4. Street parking is available on Hudson Street, Jefferson Street and Retreat Avenue (SP on map).
1
Valet Services*
Hours of Operation:
• In front of the hospital’s main entrance (#1 on the map), Monday
through Friday (excluding holidays) From 5:30 a.m. to 10 p.m.
Saturday and Sunday 9:00 a.m. to 4 p.m.
Valet Fee: Valet services require a fee of $5 for four or less hours of
parking; $10 for four to 24 hours of parking per day.
Valet parking is free (one vehicle on the day of admission and discharge
only) for the following patients:
• Patients being admitted and
discharged (one vehicle on the day
of admission only and one vehicle
on the day of discharge only)
• Pre-Admission
Security Escort
• Dialysis and MRI patients
• One-Day Surgery
24 Hours a Day
• Emergency Department patients
• Research Administration
• GI, Endoscopy and Ambulatory
Surgery patients
• Radiology
Hartford Hospital’s Public Safety
Department will provide patients,
visitors and staff with personal
escort service.
To request an (on campus) escort, or
for any assistance during your use of
our garages or valet service, please
contact our Public Safety Department at
860.545.2147. If valet service is closed,
please see the public safety officer in the
Emergency Department for assistance.
2
• Rehabilitation Department patients
on day of admission and discharge
• Maternity
• Sleep Lab
3
• Handicapped parking
Parking is free on admission and discharge, but you must park in the
Valet Parking Lot. Please inform the valet staff, that you are admitting
or discharging a patient, and you will not be charged.
parking is CLOSED on holidays If you are being admitted or
*Valet
discharged on a holiday, please park in the Public Parking Garage
and the staff at the Information Desk will validate your ticket.
Self-Parking
Garage Hours
Garage Hours of Operation:
The Public Parking Garage is attached
to Hartford Hospital’s Medical Office
Building at 85 Seymour Street and is
accessible 24 hours a day. Cashiers
are available Monday through Friday
from 6:30 a.m. to 10 p.m. During off
hours, please see the Security Officers
stationed at the entrance to our
Emergency Department.
The Retreat Avenue Garage is open
weekdays from 6:30 a.m. to 7 p.m.
It is not open on weekends.
Garage Rates: Garage parkers will be
charged $1 per hour (or any part of)
up to a maximum daily rate of $8
(per 24 hours). Valet service is $5 for
four or less hours of parking, $10 for
four to 24 hours per day.
24 hours to 48 hours is $8.00 plus an
additional $1.00 / hour to a maximum
of $16.00
48 hours to 72 hours is $16.00 plus an
additional $1.00/hour to a maximum
of $24.00
*Note: There is a 15 minute grace period
after each hour
Directions to Hartford Hospital
From West (I-84): Take exit (48) to Capitol Avenue
exit (48B) then left onto Capitol Avenue and right
onto Washington Street. Drive through four traffic
lights. At the fifth light (just past the Jefferson
Street light), turn left into the driveway. The Public
Parking Garage entrance is on the left, across from
Connecticut Children’s Medical Center.
From East (I-84): From I-84 westbound, take the
Downtown Hartford exit (54) and continue in the
left lane toward the Old State House. Turn left
onto *Prospect Street and travel south to Charter
Oak Place. Turn right at the light and turn left at
the first light onto Main Street. Continue south to
Jefferson Street (second traffic light on Main Street).
At this intersection turn right onto Jefferson Street.
At the second light turn left onto Seymour Street.
Turn right (traveling between the 85 Seymour Street
Medical Building on the right and Connecticut
Children’s Medical Center on the left); the Public
Parking Garage is on the right side.
* Alternate Route: If Prospect Street is not accessible,
continue west between the Old State House and
Travelers Tower, staying in the left lane. Turn left
at the light onto Main Street, traveling six-tenths of
a mile (8 traffic lights) to Jefferson Street.
From North and South (I-91): From Interstate 91
take the Capitol Area exit (29A), under the Hartford
Library (NOTE: Heavy construction is ongoing
in this area, and lanes may be reduced to one at
points on weekends). Continue three-quarters of
the way around Pulaski Circle turning right onto
Hudson Street. Proceed to the end of Hudson
Street. Turn right onto Jefferson Street. At next
light, take a left onto Seymour Street. Turn right
(traveling between the 85 Seymour Street Medical
Building on the right and Connecticut Children’s
Medical Center on the left); the Public Parking
Garage is on the right side.
From the Norwich (Route 2) Area: Follow Route
2 West all the way to the end, and take the Downtown Hartford exit, continuing in the left lane
toward the Old State House. Turn left onto
*Prospect Street and travel south to Charter Oak
Place. Turn right at the light and turn left at the
first light onto Main Street. Continue south to
Jefferson Street (second traffic light on Main Street).
At this intersection, turn right onto Jefferson Street.
At the second light turn left onto Seymour Street.
Turn right (traveling between the 85 Seymour Street
Medical Building on the right and Connecticut
Children’s Medical Center on the left); the Public
Parking Garage is on the right side.
* Alternate Route: If Prospect Street is not accessible,
continue west between the Old State House and
Travelers Tower, staying in the left lane. Turn left at
the light onto Main Street, traveling six-tenths of a
mile (8 traffic lights) to Jefferson Street.